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Agrahara Insurance Scheme was introduced by Ministry of Public Administration Home Affairs Circular No. 5/1997 and this scheme was implemented from 1st January 2006 under the National Insurance Trust Fund. In the early days, the Sri Lanka Insurance Company transferred an excessive amount of claim payments to our company, but now Agrahara Insurance is being run as usual by finalizing the outstanding claim payments. The primary objective of the Agrahara Medical Insurance Scheme is to improve the living conditions of all state and provincial government officials and their family members. Therefore, our organization is obliged to pay all the claims received by us as soon as possible. If all relevant documents can be submitted without defects, your claim We will pay within a few days.

FOR WHOM

The National Insurance Trust Fund provides accident insurance to nearly 1.5 million government employees and their dependents, covering all medical (hospitalization, childbirth, surgery, heart surgery, spectacles, miscellaneous), accidental and death claims. get

BENEFICIARIES

·            Married Employees- Member, spouse and children (children must be unmarried and under 21 years of age).

·            Unmarried Employees- Member, Parents (Parents must be below 70 years of age).

·         How to send monthly verification documents related to Agrahara Insurance Scheme 

·         Claims are paid as per the circulars issued by the Ministry of Public Administration and Home Affairs.  

 

LIST OF BENEFITS PROVIDED BY AGRAHARA

Aghara General Scheme     

 

Type of benefit	Maximum payment (for one event) Rs.	period	Fee (for one day) Rs.	Limit (for one year) Rs.
Private hospital room charges	30,000.00	10 days	3000.00	150,000.00
Govt. Hospital Room Charges	5,000.00	10 days	500.00	150,000.00
Pvt Hospital Surgical & Medical Treatment	50,000.00	-	-	150,000.00
Consultation Fee	20,000.00	-	-	150,000.00
Medical Test	20,000.00	-	-	150,000.00
Cataract Operation	20,000.00	-	-	150,000.00
Paralysis Package	100,000.00	-	-	150,000.00
Heart Surgery Pkg bill for Family Member	100,000.00	-	-	150,000.00
Heart Surgery Detailed bill for Family Member	100,000.00	-	-	150,000.00
Cancer Insured Package	120,000.00	-	-	200,000.00
Total Knee Replacement Set	50,000.00	-	-	150,000.00
Total Hip Replacement Set	50,000.00	-	-	150,000.00
Spinal Fusion Set	50,000.00	-	-	150,000.00
Bone Metal Stents Family	50,000.00	-	-	150,000.00
Govt. Hospital Childbirth *	2,500.00	5 days	500.00	2,500.00
Pvt Hospital Childbirth- Normal *	10,000.00	5 days	2,000.00	10,000.00
Pvt Hospital Childbirth- Cesarean *	40,000.00	-	-	40,000.00
Spectacles **	3,500.00	-	-	3,500.00
Permanent Total Disability	600,000.00	-	-	600,000.00
Permanent Partial Disability	300,000.00	-	-	300,000.00
Temporary Partial Disablement	26,000.00	52 weeks	500.00	26,000.00
Natural Death Insured	150,000.00	-	-	150,000.00
Accidental Death Insured	600,000.00	-	-	600,000.00
Kidney Insured Package	200,000.00	-	-	200,000.00
Pvt. Hospital Bypass for Member	500,000.00	-	-	500,000.00
Bare Metal Stents- Member	120,000.00	-	-	500,000.00
Drug Eluting Stent- Member	290,000.00	-	-	500,000.00
Dilatation Catheter- Member	36,000.00	-	-	500,000.00
PTCA Balloon- Member	39,500.00	-	-	500,000.00
Guide Wire- Member	12,500.00	-	-	500,000.00
Patent Ductus Arterius (PDA)	145,000.00	-	-	500,000.00
Atrial Spatial Defect (ASD)	293,000.00	-	-	500,000.00
Ventricular Spatial Defect (VSD)	293,000.00	-	-	500,000.00
Pace Maker (Singal)	136,000.00	-	-	500,000.00
Pace Maker (Dual)	272,000.00	-	-	500,000.00
PFO Occluder	293,000.00	-	-	500,000.00
Implantable cardioverter defibrillator (ICD)	300,000.00	-	-	500,000.00
Radio Frequency Ablation (RF Ablation)	225,000.00	-	-	225,000.00

 

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